Georgetown University offers a variety of dental insurance plan options to eligible employees and their families.
You are eligible to participate in University-sponsored dental benefits if you are:
- A administrative staff member hired to work 30 or more hours per week;
- An academic employee working 75% time or more; or
- A full-time Law Center Fellow
- A full-time Postdoctoral Fellow
Delta Dental PPO Plus Premier – Standard Plan This plan provides basic coverage for routine exams, cleanings and other basic services at an affordable premium. The plan pays up to $1,000 per member each calendar year. Orthodontia is not covered. Discounts on eligible services extend after calendar year maximum is met.
Delta Dental PPO Plus Premier – Enhanced Plan This plan provides expanded coverage, including periodontal and prosthodontic services, up to $2,000 per member each calendar year. In addition, the plan provides up to a $2,000 lifetime maximum orthodontia benefit for dependent children up to age 19. Discounts on eligible services extend after calendar year maximum is met.
The Delta Dental PPO Plus Premier program combines two of Delta’s national dental networks—Delta Dental PPO and Delta Dental Premier—giving you access to dentists that participate in both. There are many advantages when you use a dentist who participates—and nationally, 3 out of 4 dentists belong to Delta Dental networks. Plus, if your dentist participates in the Delta Dental PPO network you’ll save even more money because you’ll receive services at a reduced rate resulting in lower out-of-pocket expenses.
Finding a Delta Dental PPO Dentist
A current listing of dental offices that are part of Delta Dental’s networks can be found using the online dentist directory.
- Visit www.deltadentalins.com
- Click on “Find a Dentist”
- Select “Delta Dental PPO” or “Delta Dental Premier” and the state in which you wish to search
Is your current dentist a Delta Dental PPO dentist?
It is recommend that you verify your current dentist’s participation in the Delta Dental PPO network. Simply asking if a dentist “accepts Delta Dental” does not guarantee that they are a PPO dentist. Make sure you specifically ask if he or she is a contracted Delta Dental PPO dentist. Furthermore, it is also recommend that you verify your dentist’s participation before each dental appointment.
When you can’t find a PPO dentist…what next?
The Delta Dental Premier® network — Delta’s larger network — provides cost-saving features and is the next best option when you can’t find a PPO dentist. If you must visit a non-PPO dentist, a Delta Dental Premier dentist will usually save you more money than if you visit a non-Delta Dental dentist. While Premier dentists’ contracted fees are often slightly higher than PPO dentists’ fees, Premier dentists will not bill you above Delta Dental’s approved amount; non-Delta Dental dentists may bill you up to their full fees, a practice called “balance billing.” You can find a Premier dentist using the online dentist directory.
What if you can’t find your dentist in the directory?
Delta Dental recognizes that many people have a long-standing relationship with their dentist and may not want to change dental providers. You are invited to recommend your dentist for inclusion in the Delta Dental PPO network. Please visit the “Find a Dentist” page on Delta’s web site and complete the “Recommend Your Dentist” form. Delta Dental will contact your dentist to provide more details. You can help by telling your dentist how important your PPO benefits are to you and that you would like him or her to consider becoming a Delta Dental PPO dentist.
To obtain dental care, let your dentist know that you have a Delta Dental PPO plan through Georgetown University. Then simply provide your dentist with your name, date of birth and enrollee ID or social security number. Your provider will be able to locate your record the Delta Dental system, or can call to quickly determine your eligibility and benefits. If you would like an ID card for your records you can easily print one by registering and logging in to deltadentalins.com.
Please note that because the primary enrollee’s name is used to verify coverage, only that person’s name will appear on the ID card; however, the same card can be used by any eligible dependents.
The Aetna Dental Maintenance Organization (DMO) is a managed care program offering a network of Metro DC area dentists. If you enroll in the Aetna DMO, you must select a dentist from the DMO network for all of your dental care. The DMO offers 100% coverage for all preventive care and most covered services, with a $10 copay per visit. There is no deductible and no annual maximum on benefits. Please note that dental implants are NOT covered under this plan.
Orthodontia for eligible participants is covered at 50%. Eligible participants are dependent children whose treatmeant begins before age 19. There is a lifetime limit on orthodontia of one time per patient.
When enrolling in the Aetna DMO, you are required to choose a dentist for yourself and for each dependent you are enrolling. To search for available dentists in the Metro DC area who participate in the Aetna DMO and who are accepting new patients*, complete the following steps:
- Go to DocFind
- In the “Search for” drop-down box, select Dentists (Primary Care)
- In the “Type” drop-down box, select “Primary Care Dentists (PCD)”
- Enter your geographic requirements (must be within Metro DC area)
- In the “Select a Plan” drop-down box, select “Dental Maintenance Organization (DMO)”
- Click the “Search” button to view results.
*To narrow your search to display only those providers who are accepting new patients, once you have reached your search results, click on the “Change my Search Settings” button in the top right-hand corner. When you click on this button, the website will display addition criteria, including a field that says “Accepting New Patients”. Select “Yes” from this drop-down field and then click the “Search Again” button.
In order to obtain care under the Aetna DMO, you will need to designate a Primary Care Dentist. To do so, follow these steps:
- Contact the office of the dentist chosen from the DMO network
- Verify that the dentist is still a participant in the Aetna DMO
- Verify that the dentist is accepting new patients
- Call Aetna Member Services at (800) 843-3661 with your Member ID and the dentist’s Primary Office Number on hand. A member services representative will assist you in designating your Primary Care Dentist.